ShenRock Information Form Spring 2019

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PLEASE Fill out a separate and distinct form for EACH rider in your family!

Completion of this form is a requirement to participate in the Spring 2019 Season and indicates to us that your youth is planning on joining us on the trails. Questions? Please contact Kyle Lawrence- SVBCoalition@gmail.com or (571) 277-8121

Email *

Parent/Guardian Name *

Phone Number for Parent/Guardian *

First Name of Child/Team Member *

Last Name Child/Team Member *

Nickname?

Date of Birth for Child/Team Member *

YYYY

Age as of April 1, 2019? *

Current Grade for Child/Team Member (9 year-old minimum) *

School *

Harrisonburg High School

Spotswood High School

East Rockingham High School

Turner Ashby High School

Thomas Harrison Middle School

Skyline Middle School

Montevideo Middle School

Elkton Middle School

Wilbur Pence Middle School

Other:

Required

REQUIRED!!! Have you Completed your Shenandoah Valley Bicycle Coalition Family Membership? You can complete it now: http://svbcoalition.org/join-renew/ *

Yes

Other:

REQUIRED!!! Have you Completed the Massanutten Trail Pass process for your youth rider? To include Risk and Release Waiver? You can complete the process now: http://svbcoalition.org/trail-passes/

Yes

Other:

Clear selection

Required!!! Have you Completed Your SHEN-ROCK Required USA Cycling Waiver? You can do it right now: https://www.smartwaiver.com/v/shenrockusacycling *

Yes

Other:

REQUIRED!!! Have you Completed your SHEN-ROCK Required League of American Cyclists Waiver? You can do it right now: https://www.smartwaiver.com/v/shenrockLAB

Yes

Other:

Clear selection

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